Multiple myeloma in South Cumbria 1974-80: problems of health analysis in small communities

The occurrence of seven cases of multiple myeloma over seven years in a small community 15 miles from a plant reprocessing nuclear fuel caused much local concern. A case control study of 34 confirmed cases in the health district during 1974 to 1980 revealed no excess of known risk factors among the 23 cases for whom informants could be traced. The possible effects of exposure to marine discharges of radioactive material cannot be completely ruled out, but dose estimates make this highly unlikely. Such studies are a necessary response by community physicians to the population they serve but have major practical and theoretical limitations.